SPOKANE, Wash. — More than 500 people have been hospitalized and eight killed by a mysterious respiratory illness that health officials have linked to vaping.
Two cases of severe lung and respiratory illness related to e-cigarette use and vaping have been confirmed in Spokane County, according to the state Department of Health.
The deaths have brought about a lot of questions, and sometimes even panic, especially given that federal health agencies simply put do not have many answers at this point in the investigation.
Here's what we do and do not know about the outbreak of vaping-related illnesses.
What are the symptoms?
Usually patients first feel nauseous or fatigued, and often throw up.
Then, they start having respiratory symptoms, like coughing or difficulty breathing.
If it gets bad enough to go to the hospital, doctors have tried a variety of methods of treatment, each varying in degree of success depending on the case.
Why is it happening?
It's extremely difficult for doctors to treat these symptoms because they don't know the answer to this question yet.
The symptoms look a lot like a lung infection, but doctors don't find any infectious bacteria or viruses in these patients.
In addition, patients have mostly been younger adult men who are otherwise healthy. The common denominator, of course, has been identified as vaping.
That means the symptoms are likely brought on by some combination of chemicals affecting people's lungs and body.
What kinds of chemicals are consistent with illnesses?
This is a question without a concrete answer. However, there are some trends.
Most of the patients had vaped with THC, the chemical in marijuana that gives you a high. Many of those patients had vaped with traditional nicotine at some point, too.
That raises a couple of possibilities.
One: it could be a chemical found primarily in THC pens, and especially in pens or cartridges bought off the street or otherwise modified.
Some doctors found vitamin E acetate in affected patients' lungs but many others did not, and the Centers for Disease Control has cautioned against suggesting it's any one chemical yet.
Two: it could be the result of combining chemicals from THC and nicotine vaping equipment. But not all patients vaped with both.
In fact, many patients said they never vaped with THC, although that sort of reporting can be unreliable since people may lie about drug use, especially in places where marijuana is illegal.
How do you stay safe?
Health officials' primary recommendation is to stop vaping, although they say those who do should not return to or take up cigarettes instead.
They especially say that young people, pregnant women and anyone who isn't already vaping should not take up the practice.
The CDC says those who are vaping should not use any equipment purchased from a dealer. Products bought on the street may be refilled, jury-rigged or otherwise modified in a way that's tougher to regulate and often dangerous.
Why is this happening now?
One possible answer is that this phenomenon actually isn't new and that we're just now starting to put all the evidence together and recognize the problem.
Perhaps a more likely answer is that some new chemical or chemical combination has entered the market, either the legal or illegal one, and started affecting people in unprecedented ways.
The bottom line: at this point, we simply don't have many hard answers and likely won't for a little while longer.